Legal News

Medicaid is a federal and state program that provides health care coverage to low-income people, generally children, pregnant women, parents, the disabled and elderly. Many disabled people receive Medicaid through the Social Security Administration Supplemental Security Income (SSI), welfare based program. Medicaid is administered by each individual state and the federal government sets minimum eligibility standards and provides a portion of the funding. Medicaid, known in Minnesota as Medical Assistance, is one of the biggest items in the state budget, with state outlays last year of roughly $4 billion to cover more than 700,000 people. It provides medical insurance for the poor, elderly and disabled. Medicaid information is available at your local county social services, welfare, or department of human services office. Medicaid provides inpatient and outpatient health care coverage, including many services and costs Medicare does not cover, such as prescription drugs, diagnostic and preventive care, and eyeglasses. The amount of coverage varies from state to state. In 2011, Minnesota opted for an early Medicaid expansion that provided health coverage to about 84,000 residents, most of them low-income or disabled. If you have been or currently receive Disability Insurance Benefits (DIB), Disabled Widows or Widowers Benefits or Disabled Adult Child Benefits for 24 months, you qualify for Medicare. Medicare can be at times a more comprehensive medical plan, however coverage does not begin until after a person has been on disability benefits for two years and sometimes the medical coverage may not pay for all medications. Medicare covers almost everyone 65 or older, people on Social Security disability (DIB), and some individuals with permanent kidney failure. Medicare hospital insurance (Part A) provides basic coverage for hospital stays and post-hospital nursing facility and home health care. Medicare medical insurance (Part B) pays most basic doctor and laboratory costs, and some outpatient medical services, including medical equipment and supplies, home health care, and physical therapy. Medicare prescription drug coverage (Part D) pays some of the costs of prescription medications.

Under certain circumstances, Social Security Disability Insurance (SSDI) benefits may be garnished depending on what type of debt is owed, but Supplemental Security Income (SSI) benefits may not be garnished under any circumstance. Because SSI is a needs-based program, it is determined that the recipient needs that income to survive and SSDI benefits are based on a disabled worker’s past income and taxes paid, so it is not considered “needs based.” Although private institutions like banks and other financial creditors are unable to garnish SSDI benefits, government agencies are allowed to garnish benefits. The most common types of debts that may be garnished include federal income taxes, federal student loans, child support and alimony, defaulted federal home loans and certain civil penalties. If federal taxes are owed, the Internal Revenue Service (IRS) has the power to levy up to 15 percent of benefits to pay off debt. Other agencies cannot touch the first $750 of monthly benefits. To learn more about garnishment of SSDI benefits click here.

Social Security recently released its proposed budget for 2016. Part of the budget discusses certain legislative proposals in 2016. A closer look at some of these more interesting proposals may give us some indication of what changes may be coming for Social Security in the near future. Social Security benefits to same-sex couples: Currently, Social Security provides marriage-related benefits to same-sex couples that reside in a state where same-sex marriage is legal as indicated by the Social Security Act, but is prevented from paying benefits to a same-sex couple that is legally married in one state, but lives in another state. There are some ideas about changing these current rules. More Reviews Of Those On Disability to Occur: Social Security has increased its effort to do more continuing disability reviews (CDRs) and SSI re-determinations. This is a practice where Social Security takes a second look at those who are already receiving disability benefits to ensure these people are still disabled and are deserving of benefits. Social Security was given additional appropriations for such matters through 2021, but the funding has not kept up with the agency’s goals to attempt to limit the amount of improper payments that are issued to people who are no longer disabled. This proposal is sure to get a closer look as Social Security estimated that it can recoup up to $9 for every $1 spent on conducting CDRs. Go After Fraudsters With A Vengeance: You may have heard of more stories where people have been tried, convicted and sentenced to prison time for their attempts to defraud Social Security in collecting unwarranted Social Security disability payments. In addition to more enforcement, Social Security is proposing fraud facilitators to be liable for overpayments and allow the agency to collect these overpayments that were improperly paid to third parties such as representatives. Worker’s Compensation Reporting: When a Social Security disability applicant is proven to be disabled and has also received worker’s compensation payments, Social Security needs that information to offset any potential Social Security disability benefits. Because both worker’s compensation and Social Security disability are public disability programs, laws state that a combination of these benefits cannot be more than 80 percent of what the recipient’s average earnings were when they were employed. Currently, Social Security relies on the person receiving benefits to provide this information, which can delay the processing of claims and payments. The proposal would require states, local governments and private insurance companies to provide this information to Social Security. Reallocating Funds From Retirement Trust Fund: This is a proposal that Democrats have suggested in Congress to sustain the Disability Insurance trust fund, which could see a shortage that would prevent Social Security from making full payments to disabled workers as early as 2016. This particular proposal recommends a five-year reallocation of payroll taxes from the retirement trust fund to the disability trust fund. The retirement trust fund is in a bit better shape right now than the disability trust fund and similar types of transfers have occurred many times in the past to sustain the two programs. Unfortunately, the Republicans in Congress have already blocked any proposal to complete these transfers and it remains to be seen if they will eventually come to their senses before it becomes too late. As you can see, Social Security has a lot of proposals on the table for Congress to consider as part of its 2016 budget. Obviously not all of these proposals will be enacted or even considered, but some should get some strong consideration and even possibly garner some bipartisan support – dare we say it. All those with an ambitious nature may click here to learn all of Social Security’s proposals in 2016.

Get ready for the word “reallocation” to become prevalent in the political landscape as we continue through this year and probably even as we move into the presidential election year of 2016. According to Webster’s online, the definition of reallocation is “a share that has been allocated again.” This may not mean a lot to Americans, but what it refers to certainly will. The word is at the forefront of debate between Republicans and Democrats in congress over what to do about the Social Security Disability Insurance (SSDI) trust fund that is expected to be depleted by as early as next year. If nothing is done, those who receive SSDI payments because they are unable to work, can expect to see nearly 20 percent less in monthly benefits. Considering the average monthly payment for SSDI is around $1,200 per month, a 20 percent reduction can certainly result in tougher financial times for many who barely survive on their current benefits. President Barack Obama and other Democrats have proposed “reallocating” money from the Social Security retirement trust fund to the SSDI trust fund to extend the life of SSDI so that disabled workers don’t see pay cuts, but Republicans are currently blocking any plans to do this even though congress has transferred funds between the two programs, disability and retirement, 11 different times and most recently in 1994. The Republicans instead of coming up with a solution for the shortfall in the SSDI program have called for a commission to recommend changes to the program. There is no doubt that substantial changes need to occur to sustain the Social Security disability and retirement programs for years to come and we should all be open to any and all solutions. That sort of substantial change is certainly going to take while to achieve and the Republicans should stop being obstructionists and allow for a common procedure congress has enacted many times before so our disabled workers don’t have to worry about trying to survive on less income than they already have to today.

A common term you will hear Social Security disability insiders refer to is SGA, which stands for Substantial Gainful Activity. This is a standard Social Security created to determine, regardless of someone’s impairments, whether someone can earn enough money to live on, or if they fall short of this amount, should they be considered disabled. According to Social Security, those who are earning above SGA, which for 2014 is $1,070 per month worth of gross income from work-related activities, are not eligible for Social Security disability payments because they are already gainfully employed. We can argue all day about Social Security’s assessment that someone earning $1,070 per month is “gainfully employed,” because minimum-wage workers earn more than that, but Social Security’s rules are Social Security’s rules. Some even decent paying jobs would put a worker over the SGA limit just by working on a part-time basis. Fortunately, Social Security had allowed for Impairment Related Work Expenses (IRWE) that should be considered deductible if a worker is over SGA. The IRWEs are costs that an impaired worker incurs for special services or equipment that are related to a disability and necessary for someone to work. If someone has to pay IRWEs, then Social Security should deduct the cost from their earnings. This can help keep income under the SGA level in some circumstances. Below are some examples of items that SSA may consider to be IRWEs. The cost of paying for specialized transportation to get to and from work. The cost of hiring someone to help you get ready for work in the morning. The cost of hiring a non-impaired person to do part of your job that you are unable to do because of a disability. The cost of training that is needed to learn how to use impairment-related specialized equipment needed for your work. To learn more about IRWEs click here.